Individual
MR. ROBERT DAVID CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
25 BEDELL ST, PORTLAND, ME 04103-1705
(207) 252-8739
Mailing address
25 BEDELL ST, PORTLAND, ME 04103-1705
(207) 252-8739
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC10291
ME
Other
Enumeration date
04/02/2007
Last updated
06/17/2011
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